nursing management in the local public health system
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Nursing Management in the Local Public Health SystemTRANSCRIPT
Nursing Management in the Local Public
Health SystemAligato – Bajarias - Banzon – Daaca – Hortezano – Odal -
Palmez - Parantar – Sajulga – Sinogaya – Villamero - Tinoy
MANAGEMENT (Rakich, Longest & Donovan) - It is a set of
interactive processes through which the utilization of resources results in the accomplishment of organization objectives
(Kast & Rosenzweig) - is the primary force within an organization that coordinates the activities of the subsystems and relates them to its environments
LEVELS OF MANAGEMENT Top managers: Responsible for overall
operations.
Middle managers: coordinate nursing activities of several units.
First line managers: (supervisors, or head nurses.) directly responsible for the actual production of nursing services.
MANAGEMENT FUNCTIONS
MANAGEMENT PROCESS : Planning Organizing Staffing Directing Controlling
PLANNING Includes defining goals and objectives; Developing policies and procedures; Determining resource allocation; Developing evaluation methods. Budgets are used in planning.
ORGANIZING The personnel can implement the plans with
efficiency and effectiveness; Includes identifying the management structure to
accomplish work; Determining communication processes; and coordinating people, time and work.
STAFFING Recruiting, selecting, orienting developing
personnel to accomplish the goals of the organization.
Determining assignment systems , case method, functional, team, primary nursing.
Schedules to meet the needs of the clients, personnel, and institution.
LEADING (or directing) (Direct personnel and activities to accomplish the
goals of the organization) Motivating and leading personnel . Knowledge of one’s leadership style . To get work done by others . Tasks require good communication skills and
assertive behavior
CONTROLLING Ensures progress toward objectives according to
plan and involves setting standards, measuring performance against those standards
• Analyzes results to evaluate a accomplishments and includes evaluating employee performance;
• Analyzing financial activities;• Monitoring quality of care.
SUPERVISORS POSSESS FOUR TYPES OF SKILLS
1. Technical skills: Involve methods, procedures, techniques & knowledge of work being performed.
2. Human relations skills: ability to motivate and lead others and to manage conflict.
3. Administrative skills: ability to perform the planning, organizing and controlling functions
4. Decision-making/problem solving skills: ability to critically analyze information and problems and make appropriate decisions.
RESPONSIBILITIES OF THE DIFFERENT LEVELS OF MANAGEMENT1. Setting objectives2. Planning strategy3. Setting goal-short-
term objective4. Developing company
philosophy5. Setting policies-the
plan6. Planning the
organization7. Providing personnel
8. Establishing procedures9. Providing facilities10.Providing capital 11.Setting performance
standards12.Initiating management
programs13.Developing management
informations systems14.Activating people
MANAGEMENT IN PUBLIC HEALTH
Public health in the Philippines setting- Is a unique undertaking given the different macro
and micro contexts of the local public health organization – • Government policies• Programs of the national government• National an local health budgets• Geography • Political dynamics• Local culture
THE LOCAL PUBLIC HEALTH ORGANIZATION
Health Department - serving as the governing agency, a department in the local government unit
LGU (Local Government units)and the local leaders – providing services to communities and individuals
RHU (Rural Health Units) – exist in every municipality to improve access to healthcare
PHN (Public Health Nurses) and Midwives – are assigned to the different health centers
STANDARD HEALTH SERVICES
HEALTH CENTERS PROVIDE:• Immunization• Prenatal and postnatal care• Consultations• Laboratory and diagnostic examinations• Emergency medical care• Treatment of common illnesses• Referral to hospitals
PHN AS A MANAGER AND SUPERVISOR PLANNING
Nurses participate in planning for the whole local health organization.
A component of the organization’s plan is a nursing unit plan.
PHNs are exposed to, and participate in different types of plans:
• Strategic plan• Operational plan• Program plan • Nursing care plan
PHN AS A MANAGER AND SUPERVISOR
STRATEGIC PLAN
Long-range plan which contains an organizational vision and mission, guiding principles, broad strategic objectives, and specific tactics projects or activities for achieving the broad objectives.
PHNs participate in reviewing the organization’s strengths, weakness, opportunities and threats (SWOT)
PHN AS A MANAGER AND SUPERVISOR
OPERATIONAL PLAN Short-range plan that generally deals with the routine activities of
the organization
Addresses the requirements for delivering health services on a daily basis
It may include training of health center staff, income generation, purchase of instruments and equipment, introduction of a new system in queuing of clients, how to improve intra-office intra-sectorial and intersectoral collaboration, participation in the training of affiliating nursing students
PHN AS A MANAGER AND SUPERVISOR
Plans should be realistic and should be acceptable to the decision-makers-the local council and the mayor
Preparing a budget for the health centers
Manual of personal policies, standards and procedures should contain all pertinent laws (such as: Magna Carta of Public Health Workers and Code of conduct and Ethical Standards)
PHN AS A MANAGER AND SUPERVISOR
ORGANIZING
Prior to RA 7160 (Local Government Code), the organizational structure of health departments or units was standard
In assessing an existing organizational structure, nurses should be familiar with some of the principles of organization
PRINCIPLES OF ORGANIZATIONDIVISION OF WORK: 1. Division of work or specialization alone can give
maximum productivity and efficiency. 2. Both technical and managerial activities can be
performed in the best manner only through division of labor and specialization.
3. A group or team of service providers (physician, nurse, midwife and others) are assigned to a specific program, service or unit.
4. In small health centers, division of work is based on position(profession)
PRINCIPLES OF ORGANIZATIONCOORDINATION:
Conscious activity of assembling and synchronizing differentiated work efforts so that they function harmoniously in the attainment of organization objectives.
Many nurses are designated as coordinators of health programs like:• EPI• NATIONAL TB PROGRM• HEALTHY LIFESTYLE • LEPROSY CONTROL PROGRAM • REPRODUCDTIVE HEALTH AND FAMILY PLANNING PORGRAM • IMCI
PRINCIPLES OF ORGANIZATION
UNITY OF COMMAND: In order to avoid any possible confusion and
conflict, each member of an organization must receive orders and instructions only from one superior (boss).
PRINCIPLES OF ORGANIZATION
AUTHORITY AND RESPONSIBILITY: Authority means a superior’s right to command and exact
obedience from his/her subordinates. If a PHN is given responsibility as an EPI coordinator she
should also be granted corresponding authority
PRINCIPLES OF ORGANIZATION
SPAN OF CONTROL: The number of subordinates reporting directly to a
superior. If a PHN is given responsibility as an EPI coordinator she
should also be granted corresponding authority PHN is the direct supervisor of midwives, determined by:
• Level of training or competence of subordinates•Degree of geographical dispersion • Level of difficulty or complexity of the supervisees’ work
NURSING IN THE ORGANIZATIONAL STRUCTURE
STAFFING
• The concern in staffing is to have an adequate number of nurses, midwives and barangay health workers for the total
• population• There should be a contingency plan in times of greater
need such as disasters• Major problem of LGUs is inadequacy of health personnel
which is mostly due to inadequate health budget• Nurses should properly and adequately document their
activities so that their proposal for increased staffing will be considered seriously
NURSING IN THE ORGANIZATIONAL STRUCTURE
LEADERSHIP
• PHN leads the midwives so that they could deliver health services and meet the targets for their respective barangays
• The challenge for PHNs is how to influence their subordinates to pursue the goals of the organization, specifically for them to:
1. Behave respectfully towards their clients2. Provide quality service3. Meet program an/or service targets4. Observe cost containment measures5. Observe organizational values such as honesty,
cooperation, and punctuality
NURSING IN THE ORGANIZATIONAL STRUCTURE
COMMUNICATION
Nurse managers communicate to their subordinates about a number of things: policies, standards, procedures and the work that need to be done
Nurses also communicate upwards-to inform, give feedback and to influence
Nurse managers also communicate with their peers from other offices
NURSING IN THE ORGANIZATIONAL STRUCTURE
DELEGATION
PHNs should delegate to save time, develop others for their future roles and responsibilities
If a midwife can do a task very well, then the nurse should delegate
NURSING IN THE ORGANIZATIONAL STRUCTURE
CONTROLLING : Important in improving service delivery because they
serve as reminders if there are deviations from targets and standards
4 Components of the control process:1. Plan, instructions, principles and standards2. Observation, measurement and comparing “what is”
with “what should be”3. Identification of weaknesses, problems, or errors4. Correcting rectifying or doing something about them
NURSING IN THE ORGANIZATIONAL STRUCTURE
CONTROLLING:Controls that could be introduced into the public
health unit, some of which are:1. Statistical reports, records eg inventory of
medicines, FP Supplies), audit, Gantt-chart or schedule activities, client feedback
Evaluation of personnel:The evaluation of the performance of government employee is mandatoryThe performance appraisal of PHNs should focus on their duties and responsibilities
NURSING IN THE ORGANIZATIONAL STRUCTURE
QUALITY ASSURANCE (QA)An important management activity to honor the health
facility’s commitment to provide quality care to its clients
1. Structure Standards – define the rules under which service must be delivered
2. Process Standards– define how the rules under which service must be delivered. These cover thee health care facility
3. Process Standards – define n the other hand, define how nursing care is provided
4. Outcome standards - define both the desired results to be achieved and the undesirable results to be avoided
NURSING IN THE ORGANIZATIONAL STRUCTURE
SENTRONG SIGLA MOVEMENT
Certification recognition program which develops and promotes standards for health facilities Joint effort bet.:
DOH – provides technical and financial assistance packages for health care
LGUs – direct implementers of health programs & prime developers of health centers and hospitals making services accessible to every Filipino
NURSING IN THE ORGANIZATIONAL STRUCTURE
NURSING AUDIT It is a method of evaluating the quality of care given
to client through the systematic review of client records
It is a process, not an outcome evaluation If the process of delivering care/service is in
accordance with established standards, then there must be quality(outcome)